大连市医疗废物管理现状及相关人员认知的调查研究

发布时间：2017-12-27 06:02

本文关键词：大连市医疗废物管理现状及相关人员认知的调查研究　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：研究背景医疗废物是指医疗卫生机构在医疗、预防、保健以及其他相关活动中产生的具有直接或者间接感染性、毒性以及其他危害性的废物[1]。医疗废物通常携带大量致病微生物,具有高危险、高污染、高致病性的特点,被我国《国家危险废物名录》列为头号危险废物。世界卫生组织将其描述为含有已知或疑似能引起人类或动物疾病的活微生物或毒素的废物[2],在国际上被看作“健康杀手”和“头号致病源”,可通过多种途径危害人体健康。《医疗废物管理条例》实施十余年来,我国医疗废物管理进入新进程,面临着众多问题与挑战,如何科学、高效、环保地处置医疗废物,形成统一的医疗废物管理标准作业化形式变得尤为重要。同时,医疗废物的科学管理作为卫生事业管理的重要课题,在医疗废物源头减量化、管理科学化、处理无害化等方面值得深入研究。研究目的掌握大连市医疗废物管理现状及相关人员认知情况,系统评估现有医疗废物管理模式,分析大连市医疗废物管理不足之处,针对具体问题提出对大连市医疗废物管理的建议,规范大连市医疗废物管理方法,以期能对医疗废物进行更为科学、高效的管理,切实保障大连市人民群众的健康与安全。研究方法本研究通过基线调查法收集大连市各级医疗机构的医疗废物产生量、处理费用、管理组织制度以及医疗废物收集、转运、处置资料,针对合格率、培训率作基准化分析,评估大连市现有医疗废物管理模式,总结医疗废物管理现状并分析其中存在的问题。通过分层随机抽样法选取303名医务人员与50名卫生监督人员作为调查对象,调查其对目前医疗废物管理情况的认知,调查数据采用Epi Data3.0建立数据库,利用SPSS20.0进行统计学分析,率间比较利用卡方检验,以P0.05为差异有统计学意义。研究结果1.大连市医疗废物管理基本情况:医疗废物安全处置制度和应急方案合格率为97.7%;医疗废物登记合格率为97.11%;医疗废物转运操作合格率为78.9%;医疗废物暂存合格率为83.7%;医疗废物集中处置率为60.2%。2.医务人员对医疗废物的认知情况:医务人员对医疗废物相关知识问答平均正确率为61.9%。多数人员认为医疗机构应从资金及人员配置等方面全方位规范医疗废物管理。3.卫生监督人员对医疗废物的认知情况:卫生监督人员对医疗废物相关法律法规的知晓率高于90%,市级监督机构优于区级,部分卫生监督人员对法律法规的变更和动向不够熟悉。研究结论1.医疗废物管理体系已形成,定级医院操作较规范:各级医疗机构已基本建立医疗废物管理责任制,医疗机构行政科室及卫生监督部门从四个方面全面管理,医疗废物处置规范率逐年上升。2.医疗废物产生量较大,缺乏专项处置资金:医疗废物产生量增大导致其处理费用随之增长,医疗废物管理缺少专项资金,许多工作不能顺利开展。3.基层医疗机构医疗废物处理规范性有待加强:与定级医院相比,基层医疗机构在医疗废物处理各环节均存在一定问题,部分村卫生室位置偏远,医疗废物难以集中处置。4.卫生从业人员对医疗废物知识认知程度较低:部分医务人员对医疗废物管理重要性认识不足,职业防护意识薄弱,医院虽有医疗废物培训制度,但相关培训效果较差。5.医务人员与卫生监督人员对医疗废物管理认知存在差异:医务人员与卫生监督人员对医疗废物管理的认知差异影响了双方在医疗废物管理的工作重点,导致医疗废物的管理中存在漏洞。对策建议1.严格执行医疗废物法律法规:建立医疗废物管理长效机制,保证医疗废物的规范管理,对医疗废物管理实施全面监督,责任落实到个人。2.设立医疗废物处理专项资金:目前医疗废物管理过程中存在问题的主要原因可以归纳为资金及人员的短缺,建议为医疗机构及主要产生医疗废物的科室设立专项资金,缓解科室压力。3.制定本市医疗废物评价考核体系:医疗机构应对工作人员进行针对性专门培训,医疗废物知识应纳入科室日常学习中一部分,确保相关管理人员和从业人员掌握国家相关法律法规,掌握医疗废物分类收集、运送、暂存的正确方法和操作程序,定期考核并计入科室绩效。4.加强医疗废物危害的宣传教育,通过晨会、媒体宣传等途径提高相关从业人员对医疗废物管理的重视度。
[Abstract]:Background medical waste refers to [1] which has direct or indirect infection, toxicity and other hazardous wastes produced by health care institutions in health care, prevention, health care and other related activities. Medical waste usually carries a large number of pathogenic microorganisms. It is characterized by high risk, high pollution and high pathogenicity. It is listed as the number one hazardous waste in China's national list of hazardous wastes. WHO describes it as a waste [2] containing known or suspected organisms or toxins that can cause human or animal diseases. It is regarded as "health killer" and "number one source of disease" in the world, and it can harm human health in many ways. Over the past ten years, the management of medical waste has entered into a new process. It faces many problems and challenges. How to deal with medical wastes scientifically, efficiently and environmentally-friendly and form a unified standard of medical waste management is becoming more and more important. At the same time, scientific management of medical waste as an important topic of health management is worthy of further research in the field of medical waste reduction, scientific management and harmless treatment. The purpose of the study is to grasp the cognition of the current situation of the Dalian City medical waste management and related personnel evaluation system, the existing management mode of medical waste, analysis of Dalian City medical waste management department, according to the specific problems of Dalian medical waste management advice, standardize the Dalian City medical waste management method, in order to make more scientific and medical waste efficient management, and effectively protect the health and safety of the people in Dalian city. Production and processing costs, management system and medical waste collection, transportation and disposal of data this study through the baseline survey method to collect the medical institutions in Dalian City medical waste, according to qualification rate, the training rate for benchmarking analysis, the evaluation of Dalian existing medical waste management mode, summarizes the status quo and analysis of the medical waste management the problems. By using stratified random sampling method to select 303 medical staff and 50 health supervision personnel as the research object, the investigation on the current situation of medical waste management cognition, Epi Data3.0 to establish a database using the survey data, statistical analysis was performed using SPSS20.0 rate compared with chi square test, with P0.05 as the difference was statistically significant. Results: 1. of medical waste management in Dalian City, the basic situation: the safety of medical waste disposal system and the emergency plan for the qualified rate is 97.7%; the medical waste registration qualified rate is 97.11%; medical waste transport operation qualified rate is 78.9%; medical waste temporary pass rate of 83.7%; the medical waste disposal rate of 60.2%. 2. medical personnel's cognition of medical waste: the average correct rate of medical waste related knowledge is 61.9%. Most people think that medical institutions should standardize medical waste management in a comprehensive way from the aspects of funds and staffing. 3., the cognition of health supervision staff on medical waste: the awareness rate of health supervision staff on the relevant laws and regulations of medical waste is higher than 90%, municipal supervisory agencies are better than district level, some health supervisors are not familiar with the change and trend of laws and regulations. The conclusion of the study of 1. medical waste management system has been formed, the hospital grading operation is standard: all levels of medical institutions has been basically established the responsibility system of medical waste management, medical institutions, administrative departments and health supervision departments from four aspects of comprehensive management, standardize the medical waste disposal rate increased year by year. 2., there is a large amount of medical waste production and lack of special disposal funds: the increase of medical waste volume leads to the growth of its processing fees, and there is a lack of special funds for medical waste management, and many works cannot be carried out smoothly. 3., the standardization of medical waste disposal in basic level medical institutions needs to be strengthened. Compared with the grading hospitals, there are certain problems in all aspects of medical waste disposal in grass-roots medical institutions. 4., the cognition level of medical workers to medical waste is relatively low: some medical staff are not aware of the importance of medical waste management, and their awareness of occupational protection is weak. Although there are medical waste training system in hospitals, the training effect is relatively poor. 5., there are differences in cognition of medical waste management between medical staff and health supervisors. The cognitive differences between medical staff and health supervisors on the management of medical wastes affect the focus of both sides in the management of medical wastes, resulting in loopholes in the management of medical wastes. Countermeasures and suggestions 1., strictly enforce the laws and regulations of medical waste: establish a long-term mechanism for medical waste management, ensure the standardized management of medical wastes, supervise the implementation of medical waste management and implement responsibilities to individuals. 2., set up a special fund for medical waste disposal: at present, the main reasons for the problems in the process of medical waste management can be summarized as shortage of funds and personnel. It is suggested that special funds for medical institutions and departments that mainly generate medical waste should be set up to ease pressure on departments. 3. make the evaluation system of medical waste in the city: deal with the medical staff of specialized training, knowledge of medical waste should be included in the Department daily learning part, ensure that the relevant management personnel and employees to master the relevant national laws and regulations, grasp the correct methods and procedures of medical waste classified collection, transport, temporary, regular and included in the Department's performance appraisal. 4. to strengthen the publicity and education of medical waste hazards, and to improve the attention of relevant practitioners to medical waste management through morning meetings and media publicity.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R197.1

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